June 17, 2022

Covering COVID-19 is a daily Poynter briefing of story ideas about the coronavirus and other timely topics for journalists, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

A new Kaiser Family Foundation-NPR survey attempts to understand the size of America’s debt due to health care. The figure is stunningly high.  High enough, in fact, that this would be useful background for interviewing candidates in midterm election races.

Kaiser Health News and NPR said its “reporters conducted hundreds of interviews with patients, physicians, health industry leaders, consumer advocates, and researchers.” They found that half of U.S. adults do not have the funds to pay for a $500 unexpected medical bill. And 58% of bills sent to collection bureaus are for medical expenses.

One in five adults is on some form of a payment plan to a provider to pay off a medical bill. One in 10 owes money to a family member or friend to pay off a medical bill.

People in Florida, Wyoming, Utah and Alaska average the highest medical debts, according to the survey.

The survey, which “was designed to capture not just bills patients couldn’t afford, but other borrowing used to pay for health care as well,” found:

In the past five years, more than half of U.S. adults report they’ve gone into debt because of medical or dental bills, the KFF poll found.

A quarter of adults with health care debt owe more than $5,000. And about 1 in 5 with any amount of debt said they don’t expect to ever pay it off.

Medical debt is piling additional hardships on people with cancer and other chronic illnesses. Debt levels in U.S. counties with the highest rates of disease can be three or four times what they are in the healthiest counties, according to an Urban Institute analysis.

And it is preventing Americans from saving for retirement, investing in their children’s educations, or laying the traditional building blocks for a secure future, such as borrowing for college or buying a home.

Debt from health care is nearly twice as common for adults under 30 as for those 65 and older, the KFF poll found.

About 1 in 7 people with debt said they’ve been denied access to a hospital, doctor, or other provider because of unpaid bills, according to the poll. An even greater share ― about two-thirds ― have put off care they or a family member need because of cost.


In some Texas counties, a fourth of the population has medical debt.


Mortgage rates in perspective

Mortgage rates, along with lots of other interest rates, are for sure rising. If you look at charts for 30-year fixed-rate mortgages focusing only on the last few years, the increase is alarming.


But it might be useful to put the events of this week into context. I bought my first home with a 16% fixed rate in 1980. At the time, we believed we caught the rates on a downturn. We have become acclimated to post-2008 recession low rates when, in fact, the rates that are in our windshield look a lot more like historic norms than those in our rearview mirror.


Storm closed Abbott infant formula plant (again)

Abbott says a storm that hit Michigan this week closed its infant formula factory. But, the company says, it has enough formula supply to fill needs. Abbott supplies 46.2% of baby formula in the U.S. Its Michigan factory supplies a fourth of that product. The company says it could be weeks before the factory reopens because the whole building will have to be decontaminated.

What your city can learn from a city that cut homelessness in half in one decade

Houston has not solved homelessness, but it has done something few other cities can come close to claiming: dramatically lowered the number of people who have no home.

The New York Times summarized key statistics:

  • During the last decade, Houston, the nation’s fourth most populous city, has moved more than 25,000 homeless people directly into apartments and houses.
  • The overwhelming majority of them have remained housed after two years.
  • The number of people deemed homeless in the Houston region has been cut by 63 percent since 2011, according to the latest numbers from local officials.
  • Even judging by the more modest metrics registered in a 2020 federal report, Houston did more than twice as well as the rest of the country at reducing homelessness over the previous decade.
  • Ten years ago, homeless veterans, one of the categories that the federal government tracks, waited 720 days and had to navigate 76 bureaucratic steps to get from the street into permanent housing with support from social service counselors.
  • Today, a streamlined process means the wait for housing is 32 days.

The progress comes thanks to government agencies, nonprofits, property owners and corporations finding ways to move people directly from the streets into apartments and homes without going to shelters first, which is usually the case. The move happens without a lot of the traditional drug treatment requirements. It is a concept called “housing first,” and researchers are finding evidence that it leads to positive results.

The Times cites research saying one in 14 people living in America will experience some level of homelessness in their lives. And a handful of states account for the majority of housing insecurity in America. The Times said Houston city leaders are not naive enough to think they will solve poverty or fix the problem of affordable housing.

The goal in Houston and among other cities attacking the problem is different: to make homelessness only “rare and brief,” to cite Rosanne Haggerty, the housing advocate. Five states — California, New York, Florida, Washington and Texas — now account for 57 percent of the people experiencing homelessness. Not coincidentally, it is worst in those big cities where affordable housing is in short supply, the so-called NIMBYs are powerful, and the yawning gap between median incomes and the cost of housing keeps growing. Houston fits that description. The scale of its woes does not approach what is happening in San Francisco, New York or Los Angeles. But the progress it has made in housing people is instructive and replicable. It constitutes a fragile, compelling success.

This kind of reporting is important. Journalists should investigate why things go wrong, but it is just as important to investigate why things go right. Local leaders everywhere can take inspiration and instruction from places that achieve a modicum of progress when such progress can seem unachievable.

New CDC monkeypox guidance

The U.S. has reported 72 cases of monkeypox across 18 states — a big jump since the last update of 19 cases. The Centers for Disease Control and Prevention offers new guidance:

Globally, more than 1,600 cases have been reported from more than 30 countries; the case count continues to rise daily. In the United States, evidence of person-to-person disease transmission in multiple states and reports of clinical cases with some uncharacteristic features have raised concern that some cases are not being recognized and tested.

Patients with rashes initially considered characteristic of more common infections (e.g., varicella zoster or sexually transmitted infections) should be carefully evaluated for a characteristic monkeypox rash (see images and links), and submission of specimens of lesions should be considered, especially if the person has epidemiologic risk factors for monkeypox infection.

Waiting in line to get help from Social Security

Depending on where you live, the waiting line to get help from your local Social Security office can be a long line, indeed. The Center on Budget and Policy Priorities found that Congress has cut Social Security’s operating budget by 17% since 2010 and, in some field offices, it has been cut even more. Keep in mind that these offices handled 31 million calls last year.

CNBC says:

Social Security’s staff was reduced by 15% between 2010 and 2021. Ten states lost more than 20% of their Social Security staff since 2010. They include Alaska, Indiana, Iowa, Kansas, Louisiana, Ohio, Virginia, Washington, West Virginia and Wisconsin.

Four states — Alaska, Iowa, Virginia and West Virginia — lost more than 25%. The same goes for Puerto Rico.


The offices that handle disability applications were cut even more. Imagine how important those offices are to a person who has a disability and desperately needs the Social Security payments they are entitled to but can’t get because offices keep losing workers. CNBC continues:

The agency’s Disability Determination Service employees, who decide whether people qualify for either disability or Supplemental Security Income (SSI) benefits, shrank by 16% between 2010 and 2021. Eight states lost more than 30% of their DDS staff, according to the Center on Budget and Policy Priorities. The states most affected are Georgia, Illinois, Kansas, Montana, South Carolina, Tennessee, Texas and West Virginia.

I sure would be asking candidates for Congress what they are willing to do about this. I suspect congressional offices are flooded with calls from constituents who need help with Social Security.

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Al Tompkins is one of America's most requested broadcast journalism and multimedia teachers and coaches. After nearly 30 years working as a reporter, photojournalist, producer,…
Al Tompkins

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